Physician Assistant Supervisory Agreement

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Physician Assistant Supervisory Agreement Powered By Docstoc
					                                                    86TH AIRLIFT WING
                                          Special Act or Service Award Worksheet




Name of Nominee:                         John B. Good                                                                     Pseudo SSAN:                     2249F1111
                                                                                                   Personnel Number:
Organization:                            USAF IN EUROPE CM A5                                                             German ODC:                      12345678

Office Symbol:                           DPCT

Position Title                           SUPPLY CLERK (FUND CONTROL)
(from current Postion Description)

Position Grade:                                 C-05                          Step:     04                                               Special Salary?     No


Type of Award Recommended                    SASA                    Award Period:           15 Jul - 30 Aug 2008

Recommended Award Amount                 $      5,000.00




Recommending Official Signature & Date


Recommending Official Signature Block:   I. Am the Recommending Official, LTC, USAF
                                         Chief of the Nominee

Approving Official Signature & Date


Approving Official Signature Block:      I. Am the Approver, Col, USAF
                                         Commander




2 Attachments
Justification Letter to the Nominee
Certificate (AF Form 2860)




                                                 Please print this form, sign and date it and submit it with signed attachments to
                                                            86 FSS/FSPCR for administrative approval and processing.




              --- For CPF USE Only ---
                                          Reviewed on                                               Processed to ADD on




                                         Barbara Rumpf, HR Specialist, 86 FSS/FSPCR
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